Information Collection

Corporation for National Service EXIT FORM

IC 29212 under ICR 200704-3045-005 · OMB 3045-0015.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3045-0015 Corporation for National Service EXIT FORM	Form and Instruction
3045-0015 MeMber Exit Form rev ameriC exit frm.pdf www.cns.gov	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	3045-0015	MeMber Exit Form	rev ameriC exit frm.pdf	www.cns.gov	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 146,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 99 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	146,000	96,000	50,000
Annual IC Time Burden (Hours)	8,517	2,684	5,833
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.